Scientific
Toxoplasmosis in Indo-Pacific humpbacked dolphins
(Sousa chinensis), from Queensland
R O BOWATERa, J NORTONa, S JOHNSONa, B HILLb, P O’DONOGHUEc and H PRIORd
Objective To describe the clinical signs, gross pathology,
serology, bacteriology, histopathology, electron microscopy
and immunohistochemistry findings associated with toxoplas-
mosis in four Indo-Pacific humpbacked dolphins (Sousa
chinensis) that stranded in Queensland in 2000 and 2001.
Design Clinical assessment, gross necropsy, and labora-
tory examinations.
Procedure Necropsies were performed on four S chinensis
to determine cause of death. Laboratory tests including
serology, bacteriology, histopathology and transmission elec-
tron microscopy were done on the four dolphins.
Immunohistochemistry was done on the brain, heart, liver,
lung, spleen and adrenal gland from various dolphins to
detect Toxoplasma gondii antigens.
Results Necropsies showed all of four S chinensis that
stranded in Queensland in 2000 and 2001 had evidence of
predatory shark attack and three were extremely emaciated.
Histopathological examinations showed all four dolphins had
toxoplasmosis with tissue cysts resembling T gondii in the
brain. Tachyzoite stages of T gondii were detected in the
lungs, heart, liver, spleen and adrenal gland, variously of all
four dolphins. Electron microscopy studies and immunohisto-
chemistry confirmed the tissues cysts were those of T gondii.
All four dolphins also had intercurrent disease including pneu-
monia, three had peritonitis and one had pancreatitis.
Conclusion Four S chinensis necropsied in Queensland in
2000 and 2001 were found to be infected with toxoplasmosis.
It is uncertain how these dolphins became infected and further
studies are needed to determine how S chinensis acquire
toxoplasmosis. All four dolphins stranded after periods of
heavy rainfall, and coastal freshwater runoff may be a risk
factor for T gondii infection in S chinensis. This disease
should be of concern to wildlife managers since S chinensis is
a rare species and its numbers appear to be declining.
Aust Vet J 2003;81:627-632
T
oxoplasma gondii is a protozoan parasite of worldwide
distribution that infects homeothermic animals
including primates, marsupials, birds, rodents, other
mammals and humans.1,2 In Australia T gondii is widespread
and has been described from numerous intermediate wildlife
hosts including birds such as the southern cassowary, crimson
aOonoonba Veterinary Laboratory, Queensland Department of Primary
Industries, Animal and Plant Health Service, PO Box 1085, Townsville,
Queensland 4810
bRockhampton Veterinary Laboratory, Queensland Department of Primary
Industries, Animal and Plant Health Service, PO Box 6014, Rockhampton Mail
Centre, Queensland 4702
cDepartment of Microbiology and Parasitology, School of Molecular and
Microbial Sciences, The University of Queensland, Brisbane, Queensland 4072
dYeerongpilly Veterinary Laboratory, Queensland Department of Primary
Industries, Animal and Plant Health Service, 665 Fairfield Road, Yeerongpilly,
Queensland 4105
Aust Vet J Vol 81, No 10 October 2003
rosella, satin bowerbird, domestic pigeon, regent parrot; marsu-
pials such as the koala, common wombat, brown antechinus,
kowari, mulgara, and agile wallaby; rodents such as the
domestic house mouse and brown rat; and other mammals such
as the dingo, domestic dog and cat, sheep and horse.3
Toxoplasmosis is rarely reported in marine animals but has been
recorded in a west Indian manatee,4 a California sea lion,5
seals,6,7 Atlantic bottle-nosed dolphins and a spinner dolphin.8,9
In 2000 and 2001, five Indo-Pacific humpbacked dolphins
(Sousa chinensis), stranded in Townsville, and one stranded in
Gladstone. This paper describes toxoplasmosis in four of these
dolphins, three from Townsville and one from Gladstone. We
describe the findings from necropsy, histological, immunohisto-
chemical and electron microscopic examinations.
Materials and methods
Source material
In February 2000, an Indo-Pacific humpbacked dolphin
stranded alive in Townsville, Australia (dolphin 1) and was
transported by officers of the Queensland Parks and Wildlife
Service (QPWS) to a local marine aquarium for rehabilitation,
but died 3 days later. In September 2000, another S chinensis
was found dead on the bank of a river 40 km south of
Townsville (dolphin 2). The dolphin was reported by members
of the public to be rolling from side to side in the water and
bumping into boats near a boat ramp, just before its death. In
June 2001, a third S chinensis stranded live on the foreshores of
Townsville, but died soon after stranding (dolphin 3). In July
2001, a fourth S chinensis was found dead in Gladstone harbour
(dolphin 4).
Clinical pathology
Clinical tests were only possible on dolphin 1 that stranded
alive, because all other dolphins stranded dead, or died soon
after stranding. Blood was taken from the tail vein of dolphin 1
for a complete blood count and a serum biochemical profile.
Clinical therapy
Treatment of dolphin 1 included oral antimicrobial therapy
with Clavulox palatable tablets (Pfizer, Animal Health
Australia) administered via orogastric tubing on day 1. Baytril
150 mg antibacterial tablets (Bayer Australia Ltd) and fluids
were thereafter given orally, twice daily. Despite 3 days of such
therapy, the dolphin died.
Necropsy procedure
All three dolphins that stranded in the Townsville region were
necropsied by veterinary pathologists at Oonoonba Veterinary
Laboratory, Townsville, Queensland. Necropsy of the dolphin
that stranded in Galdstone harbour (dolphin 4) was done by
QPWS officers and tissue specimens were collected and
forwarded to Rockhampton Veterinary Laboratory for histo-
logical examination.
627

Scientific
Histological preparations and serology
Tissue specimens collected from all four dolphins were fixed
in 10% buffered neutral formalin for 48 h, trimmed and
processed routinely for histology.10 Sections were cut at 5 µm
and stained routinely with haematoxylin and eosin for light
microscopy. Serum collected from dolphin 1 was tested for T
gondii antibody, using an indirect haemagglutination test kit
(Laboratoires Fumouze Division Diagnostics, Le Malesherbes,
France).
Bacteriology
Various samples of organs and tissues were taken from
dolphins 1, 2 and 3 for bacterial isolation. Samples included the
brain, kidney, lung, liver and pericardial fluid from dolphin 1;
lung, pancreas and small intestinal contents from dolphin 2;
kidney, liver, peritoneal and pleural fluids from dolphin 3.
Transmission electron microscopy
Selected sections of paraffin-embedded brain tissue from all
four dolphins were examined by transmission electron
microscopy after processing by standard methods.11
Immunohistochemistry
Immunohistochemistry for detection of T gondii antigens was
performed on selected sections of brain (dolphins 1 and 4), liver
(dolphins 2 and 4), heart (dolphins 2 and 4), lung (dolphin 4),
spleen and adrenal gland (dolphin 3) using a commercial
avidin-biotin immuno-peroxidase staining technique
(Vectastain Kit; Vector Laboratories Inc, Burlingame, CA).12
The primary antibody used was T gondii polyclonal antiserum
raised in goats (Dako Corp, Carpinteria, CA). The secondary
antibody used was an anti-goat serum raised in rabbits (Vector
Laboratories Inc). Brain and liver from mice experimentally
infected with T gondii were used as positive controls while
brains from mice that had been experimentally infected with
Neospora caninum were used as negative controls.
Results
The locations where the four S chinensis stranded in northern
Queensland in 2000 and 2001 are illustrated in Figure 1.
Clinical findings and gross necropsy
Lesions detected at necropsy included superficial, nonpene-
trating skin lacerations and wounds consistent with predatory
shark attack. All three dolphins that stranded in the Townsville
region (dolphins 1 to 3) were extremely emaciated, showing
prominence of the skull and spine. Dolphin 4, which stranded
at Gladstone was in good bodily condition. Other common
findings included wart-like skin lesions at the genital opening
(dolphins 1, 2 and 4), and the presence of several well-demar-
cated rounded ulcers (0.5 to 1.0 cm diameter) on the dorsal
surface of the tongue and soft palate (dolphins 1, 3 and 4).
Other significant clinical and gross necropsy findings for each
dolphin are presented below.
Dolphin 1
The dolphin was an adult female 245 cm in length and
weighed 117 kg. It was dehydrated, weak and ataxic, unable to
lift its rostrum above the water line to breathe, and unable to
right itself in the water, continually rolling to either side. The
right eye showed corneal opacity and the teeth were moderately
worn. At necropsy, both lungs were emphysematous with
disseminated small caseous nodules more numerous in the
628
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Toxoplasmosis
Other
Figure 1. The location of four Sousa chinensis with toxoplas-
mosis that stranded in northern Queensland in 2000 and 2001.
caudal third of both lung lobes. Fibrin tags adhered to the
pleura of the right lung and the bronchial lymph nodes were
enlarged. The pancreas was swollen and palpably hard in several
areas, and there was torsion of the omentum at the site of
attachment to the proximal duodenum. The mesenteric lymph
nodes throughout the abdominal cavity were enlarged.
Dolphin 2
The dolphin was an adult female, 247cm in length. At
necropsy, there were fibrin tags adhering to the pleura of both
lungs. The mesenteric lymph nodes were enlarged, and the
mucosal surfaces of the pyloric region and bile duct were
reddened. The stomach was distended and contained remnants
of fish bones.
Dolphin 3
The dolphin was an adult female, 232cm in length. There
was a small straight scar 1 cm long located mid-ventrally,
approximately 60 cm dorsal to the genital opening that
connected by a sinus tract to the abdominal cavity. The mesen-
teric lymph nodes were enlarged and there was haemorrhagic
fibrinous peritonitis. Fibrin adhered to the lining of the abdom-
inal wall where the sinus tract opened into the abdominal
cavity, and also to the mesentery, serosa of the stomach,
pancreas, liver, right hemi-diaphragm and pleura of the right
lung. A stingray barb, 15.2 cm long was found lodged in the
liver, surrounded by fibrous tissue, purulent exudate and fibrin.
The stingray spine was identified as belonging to Dasyatis sp (P
Last, personal communication).
Dolphin 4
This dolphin was a male, 180 cm in length in good body
condition. Gross necropsy findings were reported as unremark-
able by QPWS officers.
Serology
Dolphin 1 showed significant haematological findings
including neutrophilia (19.83 x 109/L). Serum fibrinogen
ranged from 3.6 g/L to 4.0 g/L over 3 days and was within
normal limits. Creatinine kinase rose from 232 U/L to 1526
U/L and lactic acid dehydrogenase from 1575 to 2365 U/L over
3 days.
Aust Vet J Vol 81, No 10, October 2003

Figure 2. Light micrograph showing numerous Toxoplasma
gondii cysts in the brain of Sousa chinensis, associated with
gliosis. Haematoxylin and eosin x 300.
Serum from dolphin 1 tested positive for T gondii antibody at
a dilution of 1 in 2560.
Bacteriology
A pure growth of Pseudomonas aeruginosa was isolated from
the lungs of dolphins 1 and 2. A number of bacteria were
isolated, variously from the kidney, liver, peritoneal and pleural
fluid of dolphin 3 including Clostridium perfringens,
Edwardsiella tarda, E hoshinae, Pseudomonas sp, P aeruginosa,
Vibrio alginolyticus and V harveyi. The bacteria isolated from
dolphin 3 were considered secondary invaders and will not be
considered further.
Histopathology
Significant histopathological findings from all four dolphins
are shown in Table 1. The most striking lesions were seen in the
brains, where there were large numbers of protozoan cysts,
ranging in size from 6 to 30 µm, scattered throughout the
neuropil but mainly in the brain stem and cerebrum with few
cysts found in the cerebellum (Figure 2). Many cysts appeared
to be fragmenting. Intense infiltrates of mononuclear inflam-
matory cells, consisting mainly of macrophages and lympho-
cytes, were often associated with these cysts. There were
numerous microglial nodules throughout the brain tissue but
these were not always associated with discernible cysts.
Aust Vet J Vol 81, No 10 October 2003
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Scientific
Figure 3. Light micrograph of the heart of Sousa chinensis,
showing tachyzoites (arrow) of Toxoplasma gondii within the
cardiac muscle. Note the adjacent focus of mononuclear inflam-
matory cells. H and E x 300.
Perivascular cuffs of mononuclear inflammatory cells were also
evident. Multifocal areas of necrosis were commonly observed
and these were similarly infiltrated with mononuclear inflam-
matory cells.
Organisms consistent with tachyzoite stages of T gondii were
also detected histologically in various tissues including the
parenchyma of the liver (dolphin 2), the myocardium (dolphins
2 and 4) (Figure 3), the spleen and adrenal gland (dolphin 3).
Other histological findings included purulent interstitial and
bronchopneumonia (dolphin 1), fibrinous bronchopneumonia
(dolphin 2), diffuse fibrinous bronchopneumonia and
choroiditis (dolphin 3), and diffuse interstitial pneumonia
(dolphin 4).
Immunohistochemistry
Immunoperoxidase staining performed on selected sections of
brain, liver, heart, lung, spleen and adrenal gland from the
various dolphins all tested positive and confirmed that
suspected tachyzoites present in these organs were those of T
gondii (Table 2). The immunoperoxidase staining performed on
the brain and liver of mice experimentally infected with T
gondii used as positive controls tested positive, whereas brains of
mice experimentally infected with Neospora caninum tested
negative.
629
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Scientific

Transmission electron microscopy Table 1. Significant histopathological findings from four Sousa chinensis with toxoplasmosis (dolphins 1, 2, 3
and 4) that were necropsied in Queensland in 2000 and 2001
Examination of the electron
micrographs of brain tissue in all Organ Histopathology Dolphin
cases showed numerous polyzoic 1 2 3 4
cysts within the neural tissue
Brain Non-suppurative encephalitis, gliosis, + + + +
(Figure 4). The cysts were iden-
focal necrosis & T gondii cysts present
tical in ultrastructure to those of
the cyst-forming apicomplexan Heart Occasional foci of necrosis and myocarditis - +a + +a
1
parasite T gondii. The cysts Liver Focal disseminated perivascular inflammation + + a - +a
were round in cross-section and hepatocyte necrosis
ranging from 20 to 30 µm in Peritoneal cavity Peritonitis + - + +
diameter. They were located Pancreas Pancreatitis + - - -
intracellularly within enlarged
Lungs Pneumonia + + + +a
host cells, but the host cell type
could not be discerned. The Tongue Ulceration + - + +
cysts were bounded by a thin aT gondii tachyzoites present
membranous wall (up to 40 nm + present
thick) supported by a granular - absent

ground substance. The cyst wall

did not contain any protrusions and was surrounded on the Table 2. Results of T gondii immunohistochemistry from organs of four
external surface by host cell mitochondria and endoplasmic Sousa chinensis (dolphins 1, 2, 3 and 4) with toxoplasmosis necropsied
in Queensland in 2000 and 2001.
reticulum. The cysts were aseptate and contained up to 70
bradyzoites in cross-section. The bradyzoites were elongate and Organ Dolphin
measured up to 5.2 µm in length by 1.7 µm in width. They 1 2 3 4
contained a prominent apical complex consisting of an anterior
conoid, polar ring, 8 to 10 large rhoptries and 20 to 50 smaller Brain + NT NT +
micronemes. The bradyzoites were bounded by a pellicle Heart NT + NT +
consisting of two membranes, the inner membrane being Liver NT + NT +
discontinuous at the anterior and posterior polar rings and the
Lung NT NT NT +
lateral micropore. The membranes were supported by 22
subpellicular microtubules evident in cross-section. The nucleus Spleen NT NT + NT
was located in the posterior half of the cell body and was closely Adrenal gland NT NT + NT
associated with a mitochondrion and Golgi body. The brady- + = positive
zoites contained variable amounts of endoplasmic reticulum, NT = not tested
some dense granules and occasionally some polysaccharide
granules.
Four S chinensis that stranded in northern Queensland in
2000 and 2001 had encephalitis attributable to infection with T
Discussion gondii. Clinical examination was possible in only one of these
Our findings from histopathological examination of tissues and it showed clinical signs of ataxia prior to death. The impor-
and electron microscopy are similar to other reported cases of tance of toxoplasmosis in Indo-Pacific humpbacked dolphins is
toxoplasmosis in marine mammals, in that T gondii tissue cysts uncertain. This study suggests that the disease should be of
were detected in the brain, and T gondii tachyzoites, in associa- concern to wildlife managers since the species is listed as rare
tion with focal necrosis, were detected in various other body under the Nature Conservation Act 1994. Their numbers
organs.4-9 The electron microscopical findings were consistent appear to be declining, but relatively little is known to date
with tissue cysts of T gondii and allowed differentiation from about population sizes, ecology and biology of S chinensis.13,17,18
other cyst-forming coccidia including Sarcocystis, Frenkelia, The manner in which these dolphins became infected with T
Besnoitia, Hammondia and Neospora. The cysts could be differ- gondii is uncertain. Toxoplasmosis is a parasitic disease that
entiated from those of Sarcocystis, Frenkelia and Besnoitia vari- infects only homeothermic animals.1,2 Cats are the only known
ously by the presence of a thin primary cyst wall, the absence of definitive hosts,1 and usually become infected by ingestion of
a secondary cyst wall, the absence of septae and the small size of intermediate hosts that are infected with tissue cysts of T
the zoites. They differed from those of Hammondia and gondii.1,2 Infection in intermediate hosts is by ingestion of food,
Neospora in the small size of the membranous cyst wall and the soil or water that is contaminated with oocysts of T gondii.1,14-16
reduced organelle content of the zoites, especially the number of Intermediate hosts can also be infected vertically by transpla-
rhoptries. In each of our four cases we observed large numbers cental transmission of tachyzoites or by ingestion of other inter-
of tissue cysts in the brain, and tachyzoites were observed in at mediate host containing T gondii tissue cysts.1, 2
least one other organ including the heart, adrenal gland, spleen Recent studies in the Townsville region have shown that S
and liver. The presence of numerous tissue cysts in the brain in chinensis feed on a variety of marine and freshwater fish and
all four dolphins suggested the possibility that these resulted benthic invertebrates (G Parra, personal communication). A
from the reactivation of a chronic infection through the debili- similar diet of common estuarine and reef fish, and occasionally
tating effect of intercurrent disease. All of the dolphins had cephalopods and crustaceans has been found for S chinensis in
intercurrent disease, including pneumonia (all four dolphins), South Africa and Hong Kong.17 There is no evidence to date
pancreatitis (dolphin 1) and peritonitis (dolphins 1, 3 and 4).

630 Aust Vet J Vol 81, No 10, October 2003


Figure 4. Transmission electron micrograph of an aseptate cyst
of Toxoplasma gondii in the brain of Sousa chinensis. The cyst
is contained by a membranous cyst wall (c). Within the cyst are
numerous bradyzoites (b) in cross section. The bradyzoites are
identifiable by their organelles including subterminal nuclei (n),
apical rhoptries (r) and apical micronemes (m). Bar = 1.43 µm.
that T gondii infects poikilothermic animals such as fish or
invertebrates.1 However it is possible that molluscs or crus-
taceans may mechanically concentrate T gondii oocysts, acting
as vectors for infecting marine mammals such as S chinensis.
Lindsay et al recently demonstrated that T gondii oocysts can be
removed from seawater by eastern oysters (Crassostrea virginica)
and retain their infectivity. 19 Furthermore if S chinensis occa-
sionally fed upon unusual prey such as wounded or dead
seabirds or rodents that were infected with T gondii tissue cysts,
then they may incidentally acquire toxoplasmosis.
In Australia S chinensis have a broad geographic distribution
yet exhibit some territoriality within inshore coastal areas and
do not migrate vast distances throughout their natural range.18
Recent studies on the ecology and migration patterns of S
chinensis in the Townsville region have shown that they frequent
inshore creeks, rivers and coastal areas that are highly urbanised
(G Parra, personal communication). Infection with T gondii
may thus be acquired locally under specific circumstances. The
ingestion during feeding, of water or sediment contaminated
with T gondii oocysts is one possible route of infection. It is
possible that coastal waters become contaminated with oocysts
Aust Vet J Vol 81, No 10 October 2003
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Scientific
of T gondii from sewage discharge or floods that carry sediments
contaminated with them into creeks and rivers. It may not be
coincidental that three infected dolphins stranded in the
Townsville region within a year of heavy rainfall and flooding.
Miller et al recently reported that coastal freshwater runoff is a
risk factor for T gondii infection in southern sea otters (Enhydra
lutris nereis) in southern California. 20 Coastal freshwater runoff
may similarly be a risk factor for T gondii infection in S
chinensis.
S chinensis may also acquire toxoplasmosis by direct ingestion
of infected feline faeces discarded from recreational vessels or
from feral cats. In Townsville and Gladstone, feral cats inhabit
the rock walls associated with the ports and marinas and
domestic cats are kept as pets on board boats and recreational
yachts. Domestic cats are also commonly kept as pets in house-
holds throughout Townsville and Gladstone, and cat faeces may
be discarded into sewers. Although the proportion of infected
cats excreting oocysts is generally not high in a given population
(less than 2% in most countries),1 a cat may shed millions of
oocysts in its faeces and they can remain viable at 15 to 35oC
for up to 1 year.1 Townsville has a tropical climate where the
average sea surface water temperatures vary from 24.6oC in
winter to 29.1oC in summer (Australian Oceanographic Data
Centre). Townsville sea surface water temperatures favour the
long term viability of T gondii oocysts in coastal waters. One of
the dolphins that had toxoplasmosis was from Gladstone
harbour and was thought to be one of a pod of four to six
animals regularly seen at the entrance to Auckland creek and the
adjacent marina.
A pilot survey will be conducted on the eastern coast of
Queensland to assess the significance of this disease in marine
mammals that inhabit marinas and urban coastal areas. This
could have implications for the future management of S
chinensis, especially pertaining to disposal of domestic cat faeces
in marinas and sewage systems in Australia, and for the control
of feral cat and rodent populations in coastal regions, especially
in marinas and ports.
Acknowledgments
The authors wish to thank the staff of Oonoonba and
Rockhampton Veterinary Laboratories and the QPWS field
officers in Townsville and Gladstone, particularly Kim van
Stelten, Helen Smith, David Savage, Neil Mattocks, Mark
Read, Malcolm Turner and Patrick Centurio for their help in
carcase retrieval and specimen collection. Dr Kirstin Dobbs
(Great Barrier Reef Marine Park Authority) provided informa-
tion on the conservation status of S chinensis, and assisted
during necropsies, Dr Wendy Blanshard assisted with clinical
assessment of dolphin 1, and Bill Doherty assisted with
mapping. Veterinary Pathology Services provided serum testing
for T gondii. Mr Guido Parra of James Cook University
provided valuable information and discussion on population,
feeding ecology and behaviour of S chinensis in the Townsville
region from his recent studies.
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(Accepted for publication 6 December 2002)

Idiopathic mucosal lesions of the arytenoid cartilages of 21 Thoroughbred yearlings:

1997- 2001
bnormalities of the upper respiratory tract of Thoroughbred yearlings are commonly identified during pre- or post-sale endo-
A scopic examination. Some may progress to the detriment of subsequent performance resulting in financial penalty for any
purchaser. Published studies of sales examinations make no mention of mucosal lesions of the arytenoid cartilage.
This paper reports results from the post-sale, upper airway endoscopic examinations of 3312 Thoroughbred yearlings during
a 5 year period and follows the discovery by the authors of mucosal ulcers and small granulomas on the axial surface of one or
both arytenoid cartilages at post-sale endoscopic examination. Mucosal lesions were seen in 0.63% of the yearlings evaluated
and represent the commonest documented abnormal condition of the upper portion of the respiratory tract. At subsequent
examination 15 horses had healed without complications. Two horses with bilateral ulceration developed a granuloma at each
site, while another developed a granuloma which led to arytenoid chondropathy. One horse was not available for follow up.
The authors conclude that pre-sale endoscopic examination of Thoroughbred yearlings should include careful study of the
arytenoid cartilage, particularly at the rostral margin of the vocal process. Medical therapy should be considered and progress
monitored. Lesions discovered post-sale warrant notification of the owner and sales company.
Kelly G et al. Equine Vet J 2003;35:276-281.

Medetomidine-ketamine anaesthesia induction followed by medetomidine-propofol in ponies:

infusion rates and cardiopulmonary side effects
olatile anaesthetic agents are commonly employed in equine surgical cases especially in procedures exceeding 1.5 h dura-
V tion. A major deficiency of these agents is that they are cardiopulmonary depressants and may result in a high fatality rate,
particularly when anaesthesia is maintained for 3-4 h or more. While several alternatives to inhalational anaesthesia in the
horse have been evaluated, the only injectable anaesthetic suitable for long-duration procedures is propofol which requires
combination with various α2 adrenoreceptor agonists to produce satisfactory depth of anaesthesia. However this regimen
presents problems including hypoxaemia, hypercapnia and relatively high costs.
Various propofol/medetomidine combinations of total IV anaesthesia have been used successfully, with good quality of
recovery. However inductions were inconsistent and unsatisfactory in some cases.
In this study the anaesthesia of six ponies was induced with medetomidine-ketamine and then maintained with medetomi-
dine-propofol.
Induction is reported as excellent and cardiovascular function remained stable. Recovery to standing after 4 h of anaesthesia
averaged 31.1 min and was achieved after one or two attempts.
The authors propose this IV regimen as a possible alternative to inhalation anaesthesia with potential to reduce anaesthesia-
related fatality rates in horses.
Bettschart-Wolfensberger R et al. Equine Vet J 2003;3:308-313.

632 Aust Vet J Vol 81, No 10, October 2003